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Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy

Irritable bowel syndrome (IBS) is a disorder with brain-gut-microbiome alterations. Gut-directed hypnotherapy (GHT) has been shown to improve quality of life and symptoms in IBS. This therapy targets psychological coping, central nervous processing and brain-gut interaction. Studies have also demons...

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Autores principales: Peter, Johannes, Fournier, Camille, Keip, Bettina, Rittershaus, Nina, Stephanou-Rieser, Nicola, Durdevic, Marija, Dejaco, Clemens, Michalski, Maria, Moser, Gabriele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274728/
https://www.ncbi.nlm.nih.gov/pubmed/30453528
http://dx.doi.org/10.3390/ijms19113619
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author Peter, Johannes
Fournier, Camille
Keip, Bettina
Rittershaus, Nina
Stephanou-Rieser, Nicola
Durdevic, Marija
Dejaco, Clemens
Michalski, Maria
Moser, Gabriele
author_facet Peter, Johannes
Fournier, Camille
Keip, Bettina
Rittershaus, Nina
Stephanou-Rieser, Nicola
Durdevic, Marija
Dejaco, Clemens
Michalski, Maria
Moser, Gabriele
author_sort Peter, Johannes
collection PubMed
description Irritable bowel syndrome (IBS) is a disorder with brain-gut-microbiome alterations. Gut-directed hypnotherapy (GHT) has been shown to improve quality of life and symptoms in IBS. This therapy targets psychological coping, central nervous processing and brain-gut interaction. Studies have also demonstrated effects of hypnosis on intestinal transit and the mucosal immune system. So far, no study has examined the effect of GHT on the intestinal microbiome. This study aimed at examining microbial composition, IBS symptoms, and psychological distress before and after GHT. Methods: Fecal samples were collected from 38 IBS patients (Rome-III criteria, mean age 44 years, 27 female, 11 male, 22 diarrhea-dominant, 12 alternating-type and 4 constipation-dominant IBS) before and after 10 weekly group sessions of GHT. Assessments in psychological (perceived stress, PSQ; psychological distress, HADS-D; quality of life, visual analogue scales) and IBS symptom-related variables (IBS severity, IBS-SSS; single symptoms, visual analogue scales) were performed with validated questionnaires. Fecal samples underwent microbial 16S rRNA analyses (regions V1–2). Results: Microbial alpha diversity was stable before and after GHT (chao1 2591 ± 548 vs. 2581 ± 539, p = 0.92). No significant differences were found in relative bacterial abundances but trends of reduced abundance of Lachnospiraceae 32.18 (4.14–39.89) Median (Q1–Q3) vs. 28.11 (22.85; 35.55) and Firmicutes: Bacteroidetes ratio after GHT were observable. Significant reductions in symptom severity (323 (266–371) vs. 264 (191–331), p = 0.001) and psychological distress 17.0 (12.6–21.8) vs. 12.0 (8.3–18.0), p = 0.001, and increased well-being were found after GHT. Adequate relief after therapy was reported by 32 (84%) patients. Conclusion: Reductions in IBS symptoms and psychological burden were observed after gut-directed hypnotherapy, but only small changes were found in intestinal microbiota composition. The findings suggest that hypnosis may act by central nervous impact and other factors largely independent from microbiota composition modulating the brain-gut axis, possibly alterations in vagus nerve functioning and microbiota metabolism.
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spelling pubmed-62747282018-12-15 Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy Peter, Johannes Fournier, Camille Keip, Bettina Rittershaus, Nina Stephanou-Rieser, Nicola Durdevic, Marija Dejaco, Clemens Michalski, Maria Moser, Gabriele Int J Mol Sci Article Irritable bowel syndrome (IBS) is a disorder with brain-gut-microbiome alterations. Gut-directed hypnotherapy (GHT) has been shown to improve quality of life and symptoms in IBS. This therapy targets psychological coping, central nervous processing and brain-gut interaction. Studies have also demonstrated effects of hypnosis on intestinal transit and the mucosal immune system. So far, no study has examined the effect of GHT on the intestinal microbiome. This study aimed at examining microbial composition, IBS symptoms, and psychological distress before and after GHT. Methods: Fecal samples were collected from 38 IBS patients (Rome-III criteria, mean age 44 years, 27 female, 11 male, 22 diarrhea-dominant, 12 alternating-type and 4 constipation-dominant IBS) before and after 10 weekly group sessions of GHT. Assessments in psychological (perceived stress, PSQ; psychological distress, HADS-D; quality of life, visual analogue scales) and IBS symptom-related variables (IBS severity, IBS-SSS; single symptoms, visual analogue scales) were performed with validated questionnaires. Fecal samples underwent microbial 16S rRNA analyses (regions V1–2). Results: Microbial alpha diversity was stable before and after GHT (chao1 2591 ± 548 vs. 2581 ± 539, p = 0.92). No significant differences were found in relative bacterial abundances but trends of reduced abundance of Lachnospiraceae 32.18 (4.14–39.89) Median (Q1–Q3) vs. 28.11 (22.85; 35.55) and Firmicutes: Bacteroidetes ratio after GHT were observable. Significant reductions in symptom severity (323 (266–371) vs. 264 (191–331), p = 0.001) and psychological distress 17.0 (12.6–21.8) vs. 12.0 (8.3–18.0), p = 0.001, and increased well-being were found after GHT. Adequate relief after therapy was reported by 32 (84%) patients. Conclusion: Reductions in IBS symptoms and psychological burden were observed after gut-directed hypnotherapy, but only small changes were found in intestinal microbiota composition. The findings suggest that hypnosis may act by central nervous impact and other factors largely independent from microbiota composition modulating the brain-gut axis, possibly alterations in vagus nerve functioning and microbiota metabolism. MDPI 2018-11-16 /pmc/articles/PMC6274728/ /pubmed/30453528 http://dx.doi.org/10.3390/ijms19113619 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Peter, Johannes
Fournier, Camille
Keip, Bettina
Rittershaus, Nina
Stephanou-Rieser, Nicola
Durdevic, Marija
Dejaco, Clemens
Michalski, Maria
Moser, Gabriele
Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy
title Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy
title_full Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy
title_fullStr Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy
title_full_unstemmed Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy
title_short Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy
title_sort intestinal microbiome in irritable bowel syndrome before and after gut-directed hypnotherapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274728/
https://www.ncbi.nlm.nih.gov/pubmed/30453528
http://dx.doi.org/10.3390/ijms19113619
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